Pennsylvania, North Carolina Health Insurers Seek 13-19% ACA Premium Increases

Health insurers in Pennsylvania and North Carolina have proposed significant premium increases for 2026, largely driven by rising healthcare costs and the anticipated expiration of enhanced federal premium tax credits. In Pennsylvania, insurers on the ACA marketplace, Pennie, are seeking an average 19% increase for individual plans and 13% for small group plans, marking the largest requested hikes in over a decade. Major insurers like UPMC and Highmark have requested increases ranging from 7% to 23%, with Highmark's highest increase affecting northeastern Pennsylvania. Similarly, North Carolina insurers are proposing rate hikes amid concerns that the loss of federal subsidies will lead to fewer healthy enrollees, thus increasing costs for remaining policyholders. Both states’ insurance departments emphasize their role in reviewing these requests to ensure rates are not excessive, inadequate, or discriminatory and encourage consumers to shop carefully for plans that fit their needs and budgets. The uncertainty created by regulatory changes and expiring subsidies underscores the challenges facing consumers and insurers alike as they navigate the 2026 insurance market landscape.